Divine Heritage, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

DIVINE HERITAGE, LLC

Practice address

11911 Pine Forest Dr
New Port Richey, FL 34654-1462

Phone

(813) 317-7991

NPI assigned

Sep 22, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Clarice Thomas Roberts, RN

Title

President

Phone

(813) 317-7991

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1474502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1474502400000",
    "number": "1215486071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8575 MONTRAVAIL CIR",
            "address_2": "#737",
            "city": "TEMPLE TERRACE",
            "state": "FL",
            "postal_code": "336373035",
            "telephone_number": "646-673-0044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11911 PINE FOREST DR",
            "city": "NEW PORT RICHEY",
            "state": "FL",
            "postal_code": "346541462",
            "telephone_number": "813-317-7991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE HERITAGE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-22",
        "last_updated": "2016-09-22",
        "status": "A",
        "authorized_official_last_name": "THOMAS ROBERTS",
        "authorized_official_first_name": "CLARICE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "813-317-7991",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in New Port Richey, FL
• Providers in New Port Richey, FL by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.